Healthcare Provider Details

I. General information

NPI: 1548270325
Provider Name (Legal Business Name): PHYLLIS SAGE ATWELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 WRIGHTWOOD AVE
DURHAM NC
27705-5823
US

IV. Provider business mailing address

2425 WRIGHTWOOD AVE
DURHAM NC
27705-5823
US

V. Phone/Fax

Practice location:
  • Phone: 919-903-2653
  • Fax: 919-289-5515
Mailing address:
  • Phone: 919-903-2653
  • Fax: 919-289-5515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number28609
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: